Menopause, also called the “change of life,” is a well-known cause of symptoms like hot flashes and night sweats. But skin rashes may also occur with menopause. While menopause doesn't directly cause rashes, it does increase the chances of developing some rashes, such as contact dermatitis or acne. Menopause may also worsen some pre-existing rashes. The majority of skin rashes appearing around or after menopause are not serious, but a visit to the doctor should be considered to determine the diagnosis.
Officially, menopause is the day at which you have gone 12 months in a row without a menstrual period. During the months or years leading up to this day, known as the premenopausal period, levels of progesterone and estrogen -- the female hormones -- fluctuate and begin to decline. In the postmenopausal period after menopause, these hormones decrease dramatically. Low estrogen levels reduce the production of natural oils, collagen and elastic tissue in the skin. This causes the skin to become drier, thinner, looser and less elastic, increasing its susceptibility to various rashes.
Independent of menopause, the pH level -- a measure of acidity -- in the skin changes around age 50 in both men and women, according to a review article published in the “European Medical Journal -- Dermatology” in November 2014. The skin becomes less acidic, which makes it more sensitive and more likely to develop certain rashes.
Irritating substances may produce a red, itchy skin rash called irritant contact dermatitis at the area of application. Substances that were well tolerated when younger may now become irritants as the skin becomes more sensitive around and after menopause. Acne may occur, as the reduction in female hormones leads to a relative increase in male hormones. Rosacea is a common skin disorder that typically produces a red or purple color and acne-like bumps on the face. It often begins before menopause but may worsen in the postmenopausal period. Keratoderma climactericum is a condition characterized by thickened skin on the palms and soles. It can be itchy and produce painful deep cracks in the skin.
Thyroid disorders commonly occur around or after menopause. An underactive thyroid, or hypothyroidism, can produce a rash called eczema craquele. This is an itchy red rash that looks like shallow cracks in the skin. It is caused by extremely dry skin. Graves disease, a type of overactive thyroid -- hyperthyroidism -- may lead to pretibial myxedema. This causes an “orange peel” appearance of the skin, especially over the shins.
Avoiding harsh soaps and not rubbing the skin may help reduce the chances of some skin rashes around and after menopause. Keeping the skin moist with over-the-counter moisturizers, taking showers instead of baths, limiting shower time to 5 to 10 minutes and avoiding hot showers -- keeping the temperature below 96 degrees Fahrenheit -- may also be beneficial. Regular use of sunscreen is recommended to prevent additional skin damage from the sun. Skin and hair care products labeled non-comedogenic, non-acnegenic or oil-free may reduce the chances of developing acne.
Treatment depends on the type of rash. Your doctor will indicate the most appropriate treatment when the diagnosis is established. Some treatments will be similar to those used in younger individuals. But sometimes these treatments -- such as certain acne medications -- may be too strong for sensitive menopausal and postmenopausal skin.
Reviewed by Mary D. Daley, MD.